Main body Medical records of consecutive open globe injury patients admitted and primarily treated between January 2006 and December 2016 were retrospectively reviewed. Endophthalmitis following inpatient surgery, Tordoff JM, Bagge ML, Gray AR, Campbell AJ, Norris PT (2010), Medicine-taking practices in community dwelling people aged 75 years in New Zealand, Upper lid skin bacterial count of surgical eye patients in Ibadan, Nigeria, Clark A, Morlet N, Ng JQ, Preen DB, Semmens JB (2011), Whole population trends in complications of cataract surgery over 22 years in Western Australia, Ravindran RD, Venkatesh R, Chang DF, Sengupta S, Gyatsho J, et al. Evaluation on the uveal and capsular biocompatibility shape of IOL should also be considered to prohibit lens epithelial cell migration and postoperative inflammation. Values of 24%, 25% to 49%, 50% to 74%, and >75% denote no, low, moderate, and high heterogeneity, respectively [14]. Epub 2005 Jul 13. Comparison of post-cataract surgery endophthalmitis rates using syringing or regurgitation on pressure over the lacrimal sac as a preoperative screening tool for nasolacrimal duct obstruction: An impact assessment of protocol alteration due to the COVID-19 pandemic. Endophthalmitis caused by coagulase-negative staphylococci may have less inflammatory signs, often creating difficulty in distinguishing between an infective and a noninfective etiology. Risk factors for acute endophthalmitis after cataract surgery: a Endophthalmitis after cataract surgery: epidemiology, risk factors, and The incidence of endophthalmitis after cataract surgery among the U.S. Medicare population increased between 1994 and 2001. 2023 May 25. doi: 10.1007/s00417-023-06112-2. Visual acuity and ophthalmic outcomes in the year after cataract surgery among children younger than 13 years. Gondhale H, Jaichandran VV, Jambulingam M, Anand AR, Srinivasan S, Raman R, Sharma T. Indian J Ophthalmol. Aaberg TM Jr, Flynn HW Jr, Schiffman J, Newton J. Ophthalmology. With nearsightedness, farsightedness or astigmatism, images are focused either in front of or behind the retina. The major causes of visual impairment are uncorrected refractive errors (43%) and cataract (33%) ; cataracts remain the leading cause of blindness (51%) [1]. The clinical quality criteria was assessed with the Levels of Evidence offered by Oxford Centre for Evidence-based Medicine in March 2009 [12] (Table 2). (2005), Postcataract endophthalmitis in South India incidence and outcome, West ES, Behrens A, McDonnell PJ, Tielsch JM, Schein OD (2005), The incidence of endophthalmitis after cataract surgery among the U.S. Medicare population increased between 1994 and 2001, Wallin T, Parker J, Jin Y, Kefalopoulos G, Olson RJ (2005), Cohort study of 27 cases of endophthalmitis at a single institution, Wejde G, Montan P, Lundstrm M, Stenevi U, Thorburn W (2005), Endophthalmitis following cataract surgery in Sweden: national prospective survey 19992001, Li J, Morlet N, Ng JQ, Semmens JB, Knuiman MW, et al. As we and others have previously reported, we found that patient factors such as older age and male gender are associated with a higher risk of endophthalmitis after cataract surgery. A current prospective observational study reported the intracameral cefazolin (1 mg in 0.1 ml solution) significantly reduced the rate of postoperative endophthalmitis. Influence of intraocular lens material on the development of acute endophthalmitis after cataract surgery? Patients were defined as having or not having associated endophthalmitis. A method of correcting the odds ratio in cohort studies of common outcomes, http://www.stata.com/products/stb/journals/, Recent tamsulosin exposure ( <14 days before surgery), Surgeons with low annual volume ( 150 surgeries ), Surgeons with less experience ( 110years ), Skin disinfection type ( 5% povidone-iodine ), Conjunctival disinfection type ( without povidone-iodine ), Region of cataract surgery: region 6 and 9, Without fourth-generation fluoroquinolones, Without subconjunctival antibiotics at the end of surgery*, Communication between the anterior and vitreous, Nonadministration of subconjunctival antibiotics, Extra- or intracapsular cataract extraction*, Other eye procedures during the same admission ( vitreoretinal procedure, lacrimal/eyelid procedures or adjunctive MMC for inferior filtration), Wound leak on the first postoperative day, Topical antibiotic started the day after surgery, Use of ciprofloxacin rather than ofloxacin topically after surgery, Not placing a collagen shield soaked in antibiotic, Total Number of endophthalmitis (incidence rate%), S. Epidermidis(16); P. Aeruginosa(5); GPC (other), OR: Ambulatory patients care (3.63) Residence location within city(2.27), RR: Male (1.23) Older individuals(85)(1.53) Black (1.17) Native Americans (1.72) Surgeons with low annual volume (3.8) Surgeons with less experience (1.41) surgeries performed in 2003 (1.2), RR: Without intracameral cefazolin (11.45), OR: Without intracameral cefazolin (13.6) Age(1.05) Male gender(2.96), RR: Without intracameral cefuroxime (8.57), OR:Older individuals(85)(1.34) Male gender(1.44) later year of surgery (0.94) Region of surgery 6 and 9(69). Endophthalmitis occurred 4 times more often after combined cases (cataract with other ophthalmic procedures) than after standalone cataract surgeries (0.20% vs. 0.04% of cases), and occurred in 0.35% of patients receiving anterior vitrectomy. Available at: Ng JQ, Morlet N, Pearman JW, Constable IJ, McAllister IL, et al. Background: To describe the epidemiology, characteristics, risk factors, and outcomes of post-traumatic endophthalmitis. Big data from clinical registries like the IRIS Registry has great potential for evaluating rare conditions such as endophthalmitis, including developing benchmarks, longer-term time trend investigation, and comprehensive analysis of risk factors and prophylaxis. Semmens JB, Li J, Morlet N, Ng J; teamEPSWA. Most patients (75.3%) were not familiar with premIOLs, with 58.9% not willing to consider them in the context of a 2% risk of debilitating dysphotopsia and 54.2% rejecting a 5% risk of second surgery. After Cataract Surgery: Watching for Cystoid Macular Edema 6 Leyland M, Bacon A, SL Watson. In this Seminar, we discuss the pathophysiology and classification, epidemiology, risk and protective factors, symptoms, management, complications, outcomes, controversies, and future research questions of cataracts. Conclusions: We followed the criteria used in the Endophthalmitis Vitrectomy Study (EVS) [29], not excluding any presumed acute endophthalmitis after cataract surgery (i.e., including suspected and/or confirmed cases by positive culture), because it would allow for the inclusion of more studies in order to generate more power for analyzing this relatively rare complication. (1991), National outcomes of cataract extraction. Cystoid macular edema is the most common cause of decreased vision in patients following cataract surgery, occurring much more frequently than either retinal detachment or endophthalmitis. All studies found a strong association with older individuals (85 years) (Figure 2) [17, 19 , 22, 27, 3839, 42, 56]. Our study provides summary data on the risk factors for acute POE. HHS Vulnerability Disclosure, Help Bethesda, MD 20894, Web Policies The site is secure. Incidence of endophthalmitis after phacoemulsification cataract surgery: a Meta-analysis. HHS Vulnerability Disclosure, Help All authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. and transmitted securely. Nonetheless, many studies included in this review were from Asian populations (e.g. Risk factors for endophthalmitis after cataract surgery: Predictors for Acute Infectious Endophthalmitis After Cataract Surgery Borkenstein AF, Packard R, Dhubhghaill SN, Lockington D, Donnenfeld ED, Borkenstein EM. Our population-based analysis can be used as a benchmark for quality-improvement initiatives and can assist clinicians in educating their patients regarding the risks associated with cataract surgery. Unable to load your collection due to an error, Unable to load your delegates due to an error. Methods: It may occur with certain types. Unauthorized use of these marks is strictly prohibited. Bacterial Endophthalmitis - StatPearls - NCBI Bookshelf Risk factors may include younger age, cataract surgery combined with other ophthalmic surgeries, and anterior vitrectomy. Administrative data from more than 440,000 consecutive cataract surgeries in Ontario, Canada, from April 1, 2002, to March 31, 2006. Trends in cataract surgery and postoperative endophthalmitis in Western Australia (1980-1998): the Endophthalmitis Population Study of Western Australia. Ophthalmology. The risk factors for development of endophthalmitis after cataract surgery have been identified as complex cataract procedures, the performance of simultaneous vitreous procedures, a history of diabetic macular edema or proliferative diabetic retinopathy, male sex, and certain cataract types. 2022 Jun 6;6(6):CD012131. Bookshelf Background. Risk factors for endophthalmitis after cataract surgery: Predictors for Acute-onset endophthalmitis occurred in 0.04% of 8 542 838 cataract surgeries performed in the United States between 2013 and 2017. We performed a comprehensive search through six databases, had inclusion criteria for the prospective, cross-sectional and retrospective studies. This site needs JavaScript to work properly. Cochrane Database Syst Rev. A total of 6 686 169 participants with 8 963 endophthalmitis in 42 studies were analyzed. In all proven and unproven cases, the patients had swollen lids, pain and an opaque vitreous. Epub 2012 Sep 12. 2012 Aug;38(8):1370-5. doi: 10.1016/j.jcrs.2012.03.024. 7. escrs study on prophylaxis of endophthalmitis after cataract surgery 10 8. uptake of intracameral cefuroxime as prophylaxis of postoperative endophthalmitis 13 9. risk factors for postoperative endophthalmitis identified in the escrs study 15 10. preoperative antisepsis 16 11. operating theatre 17 12. Mean 3-month postoperative visual acuity was 20/100 (median, 20/50) among endophthalmitis patients, versus a mean of approximately 20/40 (median, 20/30) among patients without endophthalmitis. Disclaimer. Postoperative Endophthalmitis After Cataract Surgery: An Update Purpose: Endophthalmitis remains a devastating complication of cataract surgery, despite improved methods of prophylaxis and surgical technique. 2007 Nov;21(11):1419-26. doi: 10.1038/sj.eye.6701996. Disclaimer. Six estimates from retrospective studies [17], [19], [22], [27], [56], [57] , and one prospective studies [31] contributed to this meta-analysis. However, this is not the return of the original . Federal government websites often end in .gov or .mil. Overall rates of endophthalmitis were calculated and grouped by patient demographics, surgical facility, season, year, and association with capsular rupture. While preoperative preparation with 5% povidone-iodine solution dropped into the conjunctival sac is the best established method of chemoprophylaxis based on the current clinical evidence, the benefit of other forms of perioperative factors remains uncertain [5], [6], [8], [24], [28], [36]. Sengillo JD, Chen Y, Perez Garcia D, Schwartz SG, Grzybowski A, Flynn HW Jr. Ann Transl Med. It may be possible to reduce the incidence rate of postoperative endophthalmitis by almost 80% with a systematic approach to the management of elderly patients, hospital stay, and clinical protocols. PDF ESCRS Guidelines for Prevention and Treatment of Endophthalmitis Endophthalmitis after Cataract Surgery in the United States: A Report Findings from this analysis suggest that there is a significant association between male gender and acute endophthalmitis. Data of demographics, injury . There are several antibacterial strategies employed to prevent postoperative endophthalmitis, with topical, intracameral and subconjunctival delivery being the most common. doi: 10.7759/cureus.30110. Acute endophthalmitis is one of the most serious complications of cataract surgery and often results in severe visual impairment. Postoperative Endophthalmitis After Cataract Surgery: An Update Careers. Relationship between surgical field contamination by patient's exhaled air and the state of the drapes during eye surgery. 59) (Figure 3). The overall OR with the cross sectional study supported this finding (OR 5.48, 95% CI 3.797.92) (Figure 7). 10.1371/journal.pone.0071731 Abstract Background: Several risk factors for acute postoperative endophthalmitis (POE) following cataract surgery have been reported but the level of evidence and strength of association is varied. Eye (Lond). Studies were included if they (i) reported cataract surgery as covariate, (ii) had exogenous acute endophthalmitis as the outcome measure, including the suspected and/or confirmed cases by positive culture, If a positive culture of a vitreous sample was obtained, we defined the case as a proven acute endophthalmitis. How Big Data Informs Us About Cataract Surgery: The LXXII Edward Jackson Memorial Lecture. Endophthalmitis (post-operative) (Exogenous endophthalmitis) Although small-incision phacoemulsification has remained the standard of care, surgeons continue to debate whether modifications in surgical technique have affected complication rates. Finally, the major setback of published studies and meta-analyses of published studies in general is publication bias. Typically, images are focused on the retina in the back of the eye. World Health Organization. Although cataract surgery is highly effective and relatively safe, owing to the enormous numbers, even uncommon surgical complications could potentially harm many patients. Postoperative Endophthalmitis - Medscape Many articles, including this one, will use the term " LASIK " to refer to all types of laser eye surgery. These databases were searched systematically using the terms [(endophthalmitis) and (cataract surgery or cataract extraction or cataract or intracapsular cataract extraction or extracapsular cataract extraction or phacoemulsification) and (risk factors or association)]. Endophthalmitis: controlling infection before and after cataract surgery Miscoding of endophthalmitis itself could be a serious concern for data quality of any epidemiological analysis. The increased risk with age was only true for the very old ages (85 years) and this result might be explained by a reduced natural immunity in this advanced age group [22], [32], [42]. (2002), In vivo study of bacterial adhesion to five types of intraocular lenses, Yoeruek E, Spitzer MS, Saygili O, Tatar O, Biedermann T, et al. Inclusion in an NLM database does not imply endorsement of, or agreement with, (2007), Topical anesthesia: possible risk factor for endophthalmitis after cataract extraction, Endophthalmitis Study Group, European Society of Cataract & Refractive Surgeons (2007), Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors, Lundstrm M, Wejde G, Stenevi U, Thorburn W, Montan P (2007), Endophthalmitis after cataract surgery: a nationwide prospective study evaluating incidence in relation to incision type and location, Ng JQ, Morlet N, Bulsara MK, Semmens JB (2007), Reducing the risk for endophthalmitis after cataract surgery: population-based nested case-control study: endophthalmitis population study of Western Australia sixth report, Kamalarajah S, Ling R, Silvestri G, Sharma NK, Cole MD, et al. Results: Few risk factors were identified. The aim of this review is to present a summary of the articles published in the last 18 months on this topic. Ophthalmology. Identifying patients at high risk of this sight-threatening eye disease is important from both the public health and clinical perspectives as this would facilitate detection of disease before the onset of irreversible visual loss enabling earlier intervention. Would you like email updates of new search results? Department of Ophthalmology, C-MER(Shenzhen)Dennis Lam Eye Hospital, Shenzhen, Guangdong Province, People's Republic of China, 2 BMC Ophthalmol. Posterior capsular rupture caused intraoperative communication with the vitreous cavity, was found to be a significant risk factor for postoperative endophthalmitis, which was well proved by in vitro experiments [71] and animal models [72], [73]. Risk factors for endophthalmitis after cataract surgery: Predictors for METHODS:A hospital-based retrospective case-control study was conducted on 194 type 2 diabetic patients undergoing cataract surgery in Rajavithi Hospital from January 2007 to December 2015. Levels of Evidence (March 2009). Massachusetts Eye & Ear Infirmary, Harvard Medical School, United States of America. There were 617 suspected acute endophthalmitis cases of 442,177 cataract surgeries over the 4 years. Lever M, Smetana N, Bechrakis NE, Foerster A. Ophthalmologie. The https:// ensures that you are connecting to the Most of the studies included in our meta-analysis reported both an OR for any risk factor and ORs after stratification (Table 3). Accessibility Heterogeneity due to study design was avoided by restricting the main analyses to the same study design respectively. I2 is the percentage of the total variation across the studies that is due to heterogeneity [13]. Pooled estimates of incidence range from 1.09-2.65 per 1,000 cataract operations Endophthalmitis remains a devastating complication of cataract surgery, despite improved methods of prophylaxis and surgical technique. The incidence of endophthalmitis decreased for extracapsular extraction over the whole period, but not for phacoemulsification over the recent 12 years. HHS Vulnerability Disclosure, Help Mencucci R, Ghelardi E, Celandroni F, Mazzantini C, Vecchione A, Pellegrini-Giampietro DE, Favuzza E, Landucci E. Ophthalmol Ther. doi: 10.7717/peerj.12305. Epub 2015 Jun 2. Identifying patients at high risk of acute endophthalmitis after cataract surgery is important from both public health and clinical perspectives as this would facilitate detection of disease before the onset of irreversible visual loss enabling earlier intervention. 2015 Aug;122(8):1625-32. doi: 10.1016/j.ophtha.2015.04.036. Risk factors and outcomes of post-traumatic endophthalmitis: a - PubMed Many reports concluded that postoperative wound defects were a risk factor for the development of endophthalmitis [65], [66] and the corneal incision at least 2.0mm in length had substantially greater resistance to incision failure [45]. This may be more difficult in a clear corneal incision. J Cataract Refract Surg. Endophthalmitis Following Cataract Surgery: Prophylaxis and - EyeWiki Tobias A sbe26: Assessing the influence of a single study in the meta-analysis estimate. AIM:To identify risk factors associated with post-cataract surgery endophthalmitis (PCE) in type 2 diabetic patients. Kessel L, Flesner P, Andresen J, Erngaard D, Tendal B, Hjortdal J. Acta Ophthalmol. Endophthalmitis after cataract surgery: epidemiology, risk factors, and evidence on protection Endophthalmitis prevention is at an interesting crossroad. Three multicenter prospective randomized partially masked control study concurred that the most pertinent finding of the protective effect against infection produced by the prophylactic use of intracameral cefuroxime (1 mg in 0.1 ml solution) compared with topical disinfection alone [28], [31], [35]. An official website of the United States government. MeSH Endophthalmitis after cataract surgery: epidemiology, risk f - LWW FOIA . The .gov means its official. In the retrospective studies, the overall OR for male gender was 1.43 (95% CI 1.29 1.58) , in the whole studies, it was 1.44 (95% CI 1.30 1. PeerJ. There were no limits placed on the year of publication. Consecutive physician billing claims for cataract surgery and specific intraoperative and postoperative procedures related to complications of cataract surgery were identified. 2015 Jun;93(4):303-17. doi: 10.1111/aos.12684. Some of the most common factors that increase the risk include advanced age, impaired immune system secondary to systemic diseases, intraocular exposure to the patient's own ocular flora,. Theories to account for more frequent POE with sutureless clear corneal incisions are centered on the stability of the surgical wound because its integrity is believed to be a critical factor. Before 1998 Jun;105(6):1004-10. doi: 10.1016/S0161-6420(98)96000-6. Unable to load your collection due to an error, Unable to load your delegates due to an error. Unauthorized use of these marks is strictly prohibited. Postcataract endophthalmitis in South India incidence and outcome. Risk Factors for Acute Endophthalmitis following Cataract Surgery: A 2023 May 4;2023:3132866. doi: 10.1155/2023/3132866. Unable to load your collection due to an error, Unable to load your delegates due to an error. However, 4% of endophthalmitis patients still achieved 20/20 or better visual acuity, and 44% achieved 20/40 or better visual acuity at 3 months. Injury Prevention Research Center, Medical College of Shantou University Shantou, Guangdong Province, People's Republic of China, 4 Doft BH, Wisniewski SR, Kelsey SF, Fitzgerald SG (2001), Endophthalmitis Vitrectomy Study Group. Endophthalmitis incidence was highest among patients aged 0 to 17 years (0.37% over 5 years), followed by patients aged 18 to 44 years (0.18% over 5 years; P < 0.0001). It was consistent with the reports of western Australia in 2011 [60] and southern India in 2009 [61]. Risk factors. instrumental surgical intervention for mature and hypermature cataracts is possible to lead to some complications concerning zonular fiber damaging, is introduced that may very well influence the results. National Library of Medicine Accessibility Nationwide surveys and large case series of postcataract endophthalmitis (POE) in different countries estimated that the incidence for endophthalmitis ranged from 0.012% to 1.3% since 2000, in part because of differences in study design, time, and region [3, 17 32]. [Infections after intraocular lens surgery: implications for refractive surgery]. HHS Vulnerability Disclosure, Help Risk factors of acute endophthalmitis after cataract extraction: a case ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Preliminary report of principal results from a European multicenter study, Wu PC, Li M, Chang SJ, Teng MC, Yow SG, et al. Nagaki Y, Hayasaka S, Kadoi C, Matsumoto M, Yanagisawa S, et al. Recent findings. 2007 Feb;33(2):269-80. doi: 10.1016/j.jcrs.2006.10.067. Eye (Lond). Risk factors and outcomes of post-traumatic endophthalmitis: a . Although various drugs have been used for this purpose, nearly all provide comparable protection. 2023 Apr 13. doi: 10.1007/s00347-023-01840-6. Publication bias was evaluated with the use of Egger regression asymmetry test and the Begg's test. doi: 10.1016/j.ajo.2015.09.028. This causes clouding of the posterior capsule. 8600 Rockville Pike The 1998 national prospective survey, Lertsumitkul S, Myers PC, O'Rourke MT, Chandra J (2001), Endophthalmitis in the western Sydney region: a case-control study, Effect of prophylactic antibiotics and incision type on the incidence of endophthalmitis after cataract surgery, Swaddiwudhipong W, Linlawan P, Prasantong R, Kitphati R, Wongwatcharapaiboon P (2000), A report of an outbreak of postoperative endophthalmitis, Schmitz S, Dick HB, Krummenauer F, Pfeiffer N (1999), Endophthalmitis in cataract surgery: results of a German survey, Bainbridge JW, Teimory M, Tabandeh H, Kirwan JF, Dalton R, et al. Risk factors for endophthalmitis after cataract surgery: Predictors for causative organisms and visual outcomes | Semantic Scholar DOI: 10.1016/j.jcrs.2015.05.027 Corpus ID: 38102485 Risk factors for endophthalmitis after cataract surgery: Predictors for causative organisms and visual outcomes M. Lundstrm, E. Friling, P. Montan Please enable it to take advantage of the complete set of features! Data extraction and evaluation of study quality were performed independently by two reviewers; any disagreements were resolved by discussion with the senior investigators. Several risk factors for acute postoperative endophthalmitis (POE) following cataract surgery have been reported but the level of evidence and strength of association is varied. 2022 Oct 9;14(10):e30110. Typically, postoperative endophthalmitis is caused by the perioperative introduction of microbial organisms into the eye either from the patient's normal conjunctival and skin flora . sharing sensitive information, make sure youre on a federal Disclaimer. Incidence of acute-onset postoperative endophthalmitis after cataract surgery. 2015 Oct;253(10):1729-33. doi: 10.1007/s00417-015-3009-z. Summary: 2003 May;87(5):574-6. doi: 10.1136/bjo.87.5.574. Careers, Unable to load your collection due to an error. All statistical analyses were performed with Stata version 11.1 (StataCorp, College Station, TX). Anterior vitrectomy performed on the day of surgery was used as a surrogate marker for capsular rupture. To report the incidence of endophthalmitis after senile cataract surgery and to describe the epidemiology and main risk factors. 1 Incidence 1.1 The incidence of endophthalmitis after cataract surgery is variable 1.2 Endophthalmitis Following Cataract Surgery at Bascom Palmer Eye Institute 2 References 3 Risk Factors 3.1 Preoperative 3.2 Intraoperative 3.3 Post operative 4 References 5 Classification, Isolates and Clinical features Nonetheless, even with these limitations in mind, we believe that our analysis provides clear evidence to support the notion that the nine risk factors for acute endophthalmitis. The endophthalmitis rate was approximately 10-fold higher in those with capsular rupture compared with those without (13.11 vs. 1.34/1000, P<0.0001), with an adjusted odds ratio of 9.56 (95% confidence interval, 6.43-14.2). Visual acuity outcomes vary; however, patients can recover excellent vision after surgery. Many patients have known or suspected bacteremia or fungemia; however, culture yield is reported to be low (approximately 50%). Can cataracts come back after surgery? - Medical News Today What Are the Risks of Cataract Surgery? - VisionAware Methods: A retrospective study was conducted on the patients who underwent cataract surgery in Qingdao Eye Hospital from January 1, 2008, to December 31, 2019, including age, sex, history of diabetes, intraoperative operation and . The whole studies did identify a significant association between silicone intraocular lens and acute endophthalmitis (OR 3.02, 95% CI 2.034.49) (Figure 9).
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